Xtreme Nails Order Form

Printable order sheet, print this order sheet, fill it out, fax it to us at 1-847-381-8145 or
this order sheet copy it to your clipboard then paste it to Microsoft Word,
Business hours Mon - Fri., 9 am. - 4 pm. Central Standard Time. Closed on weekends.
Mail to: Xtreme Nails PO BOX 3472 - Barrington IL 60010

Flat rate shipping of $5.99 on all orders within the United States.
Xtreme Nails PO BOX 3472 - Barrington IL 60010 Phone (847) 207-3102 / Fax: 1-847-381-8145 


FIRST NAME:_______________LAST NAME:_______________________________________

SHIPPING ADDRESS:__________________________________________________________

CITY:_____________________________STATE_________ZIP________________________

PHONE#:_______________________FAX#:________________________________________

EMAIL ADDRESS:_____________________________________________________________

AMEX#____________________________EXP____________4 digits on front__________

VISA#________________________EXP____________last 3 digits on back__________

M/C#_________________________EXP____________last 3 digits on back__________

DISCOVER#_____________________EXP____________last 3 digits on back__________

Item #
Description
Quantity
Unit Price
Total Price